Dobutamine stress echo-induced apical ballooning (Takotsubo) syndrome.
OBJECTIVE
We report a case of dobutamine stress echocardiography (DSE) resulting in transient apical ballooning syndrome to highlight this rare condition as a potential complication of DSE.


BACKGROUND
Takotsubo cardiomyopathy, or transient apical ballooning syndrome, is a recently described form of left ventricular (LV) dysfunction induced by stress. Clinically it can mimic acute coronary syndrome in its presentation. It is characterized by an atypical distribution of LV dysynergy with apical ballooning and compensatory basal hyperkinesis. Coronary angiography is normal. It has preponderance in females. Although the aetiology of Takotsubo syndrome remains obscure catecholamine release appears to be the principal trigger.


RESULTS
We report a case of dobutamine-induced transient LV apical ballooning in a woman without coronary disease, during a dobutamine stress echocardiogram. There was evidence of ventricular recovery by 72 h. To our knowledge, only three other case reports describe dobutamine-induced Takotsubo cardiomyopathy.


CONCLUSIONS
Dobutamine stress echocardiography is a widely performed diagnostic test, however, it can rarely result in presumed catecholamine-induced transient apical ballooning syndrome.
Margey
Ronan
R
Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. ronanmargey@physicians.ie
Diamond
Pauline
P
McCann
Hugh
H
Sugrue
Declan
D
D000318:Adrenergic beta-Agonists; D017023:Coronary Angiography; D004280:Dobutamine; D025401:Echocardiography, Stress / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging / Q000209:etiology*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
D000318:Adrenergic beta-Agonists; D004280:Dobutamine